Coding "Cardiac Dysfunction" in ICD-10

I was recently asked how to code "diastolic dysfunction" in ICD-9.  The inquirer asked if it should be coded as "heart failure, NOS based on something she had read.

In 2009, Q1, Coding Clinic noted that you could not assume heart failure in a patient with diastolic dysfunction, and that it should be coded as 429.9, heart disease, unspecified.  

The term dysfunction is very non-specific, and runs the gamut from very mild, to extremely severe.  There may be minimal dysfunction present, or life threatening dysfunction.  As with a lot of documentation, there's simply not enough information there to select a specific diagnosis code.  Therefore, the best you can do is choose a non-specific code, that is not more severe than the documentation.

In ICD-10, "heart dysfunction" is indexed to I51.89--Other ill-defined heart diseases.  This seems like it follows similar logic, and it makes sense--ill defined documentation corresponding to an ill defined heart disease.

CMS Posts Revised Instructions for Billing Services On or After 10-1-2015

CMS Medlearn Matters (MLN) has re-issued SE 1408 - Medicare Fee-For-Service (FFS) Claims Processing Guidance for Implementing International Classification of Diseases, 10th Edition (ICD-10) – A Re-Issue of MM7492.  Although this is a FFS guidance, it was referenced in the September 2015 Encounter Data Processing System Newsletter, for guidance on submission of claims/encounters on or after the 10-1 transition date to ICD-10.  There are two important new pieces of information included:

v  The submission of Inpatient Home Health Services (Part B) services—type of bill 32X * (use the thru date)

v  The submission of DME claims that span dates of service before 10-1 and on or after 10-1 (use the from date)

I think there will be a number of DME claims like this, so the update is important.

You can review the update on the CMS website, here.

* The type of bill 32X is not exclusively used for this type of service. This is only for Part B only Medicare  members who are in an inpatient hospital setting, receiving Home Health services there. 

Using Diagnoses From Prior Encounters

One of the most common questions we get is whether or not a diagnosis from an earlier encounter can be used for a current encounter.

Standard coding advice has always been that a diagnosis cannot be "pulled forward" to a new encounter. Coding Clinic, Q3, 2013 has addressed this issue.  In part, the Coding Clinic advice says:

"Conditions documented on previous encounters may not be clinically relevant on the current encounter.... However, if the condition is not documented in the current health record, it would be inappropriate to go back to previous encounters to retrieve a diagnosis without physician confirmation."

Coding Clinic indicated this advice applies to both ICD-9 and ICD-10 coding.  We hope this advice will clear up this frequent question.

Medical Record Guidance

We often get questions about what constitutes a complete medical record.  To date, there is no all-encompassing official definition, although CMS provides their requirements during a Risk Adjustment Data Validation.

For offices, groups and health plans trying to develop coding compliance policies, there hasn't been a lot of information available.  Recently, the American Health Information Management Association (AHIMA) has tackled the issue head on in Defining the Core Clinical Documentation Set for Coding Compliance.  This useful article will help anyone tasked with creating a coding compliance policy.  You can find a copy of this paper here.

Where are the New ICD-9 Codes?

Since we're already halfway through October, some people are starting to wonder where the new  ICD-9 codes are.   By this time, they're usually up on the HCCUniversity.com website for people to download.

Because of the transition to ICD-10 in October 2014, there is a moratorium on creation of new codes, except in very limited circumstances.  So, there are no new ICD-9-CM diagnosis codes for 2013.  There is also no change to instructions or the Official Coding guidelines, which were effective October 1, 2011.

There is one change-a single ICD-9 procedure code (used only by inpatient hospitals), 00.95, Injection or infusion of glucarpidase, was added.   This drug is used to treat a common side effect of methotrexate administration.

If there are any future changes to the ICD-9, we'll post it here and on HCC University.

Coding Borderline Diagnoses

A recent Coding Clinic (Q 1 2012) answered the following question:


Coders are confused as to the correct coding of “borderline” diagnosis. The advice published in Coding Clinic, First Quarter 2011, pages 9-10, appears to be contradictory. The advice instructs coders to assign code 416.8, Other chronic pulmonary heart diseases, for borderline pulmonary hypertension as if it were confirmed; however, a diagnosis of borderline diabetes without further confirmation of the disease is assigned to code 790.20, Abnormal glucose.
Should code 793.2, Nonspecific (Abnormal) findings on radiological and other examination of body structure, Other intrathoracic organ, be assigned for a diagnosis of “borderline pulmonary hypertension” or should all borderline diagnoses require clarification from the attending physician so that the appropriate code may be reported?

Coding Clinic's Advice:

"Borderline diagnoses" are coded as confirmed, unless the classification provides a specific entry (e.g., borderline diabetes). If a borderline condition has a specific index entry in ICD-9-CM, it should be coded as such.

They went on to indicate that  borderline conditions are not uncertain diagnoses, and no distinction is made between the care setting (inpatient versus outpatient). 


However, when documentation is unclear regarding a borderline condition, coders should query for clarification.

New Presentation on HCC University

There's a new presentation and quiz on HCCUniversity.com!  Check out Documentation for Ophthalmology coding.  This presentation should help Ophthalmologists and Optometrists understand ICD-9 coding requirements.  Go Here and scroll down to the first downloadable presentation!

Full Text of the 2012 ICD-9 Now Available!

The full text of the 2012 ICD-9 Code book, effective October 1, 2012 is now available on our HCCUniversity.com website.  You can download the book, including the official guidelines here: 2012 ICD-9 .

When CMS posts the update to the CMS-HCC model, we'll post them on HCC University.

Have questions about risk adjustment or ICD-9-CM coding?  Contact us at coding@scanhealthplan.com.

More Updates from Coding Clinic

On June 3 we posted several new Coding Clinic rulings.  Today, we're posting several more updates.  Keep your eyes on this space for more posts on recent Coding Clinic rulings.

Volume:  2011

Issue:  First 

Title:  Systemic Inflammatory Response Syndrome (SIRS) due to Pancreatitis

The questioner asked for clarification of the advice published in First Quarter 2010. In that issue, coders were instructed to assign code 995.93, Systemic inflammatory response syndrome due to noninfectious process without acute organ dysfunction for SIRS due to a noninfectious condition, such as pancreatitis. Because the etiology of pancreatitis can either be infectious or noninfectious, the questioner asked if the provider be queried.  

Coding Clinic acknowledged that pancreatitis can have various etiologies; however, the majority of cases of pancreatitis are non-infectious. In many cases, the cause is unknown.  If the provider documents specifically that the SIRS is due to infectious pancreatitis, use the infectious SIRS code rather than the noninfectious one.  The provider should be queried if the medical record documentation is not clear.

Volume:  2011

Issue:  First 

Title:  Borderline Diabetes Mellitus

The question of coding a diagnosis of borderline diabetes was posed.

Coding Clinic answered that code assignment should be based on physician documentation, and sometimes might require querying the physician.

If not, a diagnosis of “borderline diabetes” without further confirmation of the disease should be assigned the appropriate code from subcategory 790.2, Abnormal glucose.

Volume: 2011

Issue:  First 

Title:  Chronic Venous Embolism and Thrombosis

The questioner noted that there were codes for chronic venous embolism and thrombosis, and asked when  DVT becomes chronic.

Coding Clinic noted that there were no specific timelines for when DVT or any other condition becomes chronic. The assignment of chronic DVT is based on provider documentation.

 Volume:  s2011

Issue:  First 

Title:  Broken Catheter Tip Retrieved via Thrombectomy

The questioner noted that a patient was admitted for thrombosed arteriovenous graft. An aspiration of thrombus was performed. During the procedure, the catheter tip separated at the entry site of the sheath after access through scar tissue. Open thrombectomy was performed with retrieval of the catheter tip. What is the code assignment for the broken catheter tip?

Answer:

Coding Clinic advised the questioner to assign code 996.1, Mechanical complication of other vascular device, implant, and graft, for the broken catheter tip.

If the catheter tip had not been retrieved, codes 996.1, Mechanical complication of other vascular device, implant, and graft, and 998.4, Foreign body accidentally left during a procedure, would be assigned.

Note there is a previous Coding Clinic, First Quarter 1995, with  an example of a catheter tip that broke off during chemotherapy infusion.

2011

Issue:  First 

Title:  Broken Needle Left during Surgery

The questioner asked about a needle placed along the right lateral aspect of the sewing ring of the aortic valve and passed through tissue to try to cinch the valve down. The suture broke from the needle and the needle was lost within this tissue.  An x-ray was done which did not reveal the needle. The chest was closed and a second x-ray showed that the needle was to the right of the aortic valve. The chest was reopened but the needle still could not be located or palpated.

 The surgeon decided that continuing to look for the needle was likely to cause the patient more harm than good. Therefore, the chest was closed again, and the patient was transferred to ICU in stable condition.

The questioner asked what the correct diagnosis code assignment is when a provider intentionally leaves a foreign body in the patient and the documentation clearly states that removing the foreign body will cause more harm than good? Would code 998.4, Foreign body accidentally left during procedure, be appropriate?

Coding clinic advised to assign code 998.4, Foreign body accidentally left during a procedure. Although the surgeon made the decision to leave the needle because continuing to search for it might cause harm to the patient, it was not the intent of the original procedure to leave a foreign body behind.

Year:   2011

Issue:  First 

Title:  Coding for Home Health Care

The questioner asked if symptoms codes should be assigned along with the aftercare codes. As an example, they asked if it was appropriate to assign a code for gait abnormality when a patient is receiving home health aftercare following joint replacement? Does the advice change depending on whether this is an outpatient encounter versus an inpatient admission?

Coding Clinic answered that  symptom codes may be assigned in conjunction with V codes when they provide additional information about the specific problem being addressed. In the given example, code 781.2, Abnormality of gait, may be assigned in conjunction with code V54.81, Aftercare following joint replacement.

Year: 2011

Issue:  First 

Title:  Code Assignment Based on Up and Down Arrows

The questioner asked if it was appropriate to assign a diagnosis code for a condition listed with up and down arrows?  Examples were provided:  ↑ cholesterol, or ↑lipids, or ↓hemoglobin and hematocrit, and they wondered if a code should be assigned for hypercholesterolemia, or hyperlipidemia, or low H&H, etc.? They also wondered if the  advice changed depending on whether this is an outpatient encounter versus an inpatient admission?

Coding Clinic advised that it is not appropriate for the coder to report a diagnosis based on up and down arrows, and that diagnosing a patient’s condition is solely the responsibility of the provider.

The use of up and down arrows can have variable interpretations and do not necessarily mean “abnormal.” They could simply be indicating change (including improvement) over past results. Therefore the provider should be queried regarding the meaning of the arrows and request that the appropriate documentation of a condition or diagnosis be provided.

Coding Clinic advised that this response was consistent with the coding guideline on abnormal findings which states: “abnormal findings (laboratory, x-ray, pathologic, and other diagnostic results) are not coded and reported unless the provider indicates their clinical significance. If the findings are outside the normal range and the attending provider has ordered other tests to evaluate the condition or prescribed treatment, it is appropriate to ask the provider whether the abnormal finding should be added.” The same advice applies for both inpatient and outpatient admissions.

Recent Coding Clinic Decisions

The last quarter  2010 and the first quarter 2011 Coding Clinic rulings were recently released. Because there are so many decisions, we'll post them over the next week in small batches so that the posts aren't too long  We hope that this information is helpful to you!

Volume: 2011

Issue:  First 

Title:  Postoperative Aspiration Pneumonia

The question of the  correct code assignment for a diagnosis of postoperative aspiration pneumonia was made, noting that  ICD-9-CM’s Tabular List under code 997.39 provides the following inclusion terms: “Pneumonia (aspiration) resulting from a procedure.” The questioner went on to note that the instructional note under category 997 states, “Use additional code to identify complication.” Should code 997.39, Respiratory complications, Other respiratory complications, be assigned along with code 507.0, Pneumonitis due to solids and liquids, Due to inhalation of food or vomitus, to describe postsurgical aspiration pneumonia?

Coding Clinic answered that it was appropriate to assign both codes together. The questioner was instructed to assign code 997.39, Respiratory complications, Other respiratory complications, and code 507.0, Pneumonitis due to solids and liquids, due to inhalation of food or vomitus, for postsurgical aspiration pneumonia. Coding Clinic went on to indicate that the title of code 997.39 is broad  and that the  assignment of code 507.0 provides additional information about the specific respiratory complication.

Volume:  2011

Issue:  First 

Title:  Pancytopenia due to Drug

The questioner indicated confusion about coding drug-induced pancytopenia. Coding Clinic had previously advised how to code chemotherapy induced aplastic anemia but did not address pancytopenia secondary to drugs. The ICD-9-CM indexes pancytopenia to code 284.1, Pancytopenia. However, code 284.1 is excluded from pancytopenia due to or with aplastic anemia (284.9) as well as that which is drug induced (284.89). If the provider documents “pancytopenia due to chemotherapy” and there is no documentation of “aplastic anemia,” how is this coded?

Coding clinic answered that based on the instructional note under code 284.1, the correct code would be Other specified aplastic anemias 284.89, along with the appropriate E-code to identify the drug. Although there is no medical record documentation of aplastic anemia, the instructional note indicates that drug-induced pancytopenia is classified to code 284.89.

Volume: 2011

Issue:  First 

Title:  Transbronchial Biopsy of Lung  (inpatient procedure coding)

The questioner noted that a procedurewas listed as bronchoscopy due to nodular infiltrates and atelectasis and airway examination. In addition, washings, brushing and biopsy were taken from the left lower lobe and washings from the right lower lobe. Additionally, the provider has clarified that a transbronchial biopsy of the left lower lobe was performed. No lung tissue was identified on the pathology report. How should this be reported?

Coding clinic indicated that based on the provider’s documentation, they should assign procedure code 33.27, Closed endoscopic biopsy of lung, for the transbronchial biopsy. Although there was an absence of lung tissue in the pathology report, it did not preclude the assignment of the code when the procedure is performed by the provider. Tissue samples may be inadequate or inconclusive, leading to the lack of lung tissue in the path report.

 

Volume:  2011

Issue:  First 

Title:  Trichilemmal (Pilar) Cyst

The questioner indicated that a  patient presented for outpatient surgery for removal of a scalp lesion. The provider documented “skin lesion, scalp––excised.” The pathology report indicates “trichilemmal cyst (pilar cyst).” ICD-9-CM classifies a cyst of the scalp as a sebaceous cyst. There is confusion as to whether this should be coded as a trichilemmal or sebaceous cyst. What is the correct diagnosis code for this encounter?

Answer:

The questioner was told to assign code 704.8, Other specified diseases of hair and hair follicles, for the trichilemmal (pilar) cyst.

Volume:  2011

Issue:  First 

Title:  Postoperative Hemorrhage and Postoperative Hematoma

The questioner was concerned about  inconsistency in hospital coding of postoperative hemorrhage vs. postoperative hematoma.  They noted that when a surgical wound is slightly oozing blood and is treated with pressure, it is being coded as a postoperative hemorrhage. By the same token, if a small hematoma is noted after surgery, but not treated, it is still being coded as postoperative hematoma. Could you provide us with guidance so that we can consistently code these conditions?

Coding Clinic answered quite strongly, reiterating the Official Coding Guidelines on complications of  care:  “As with all procedural or postprocedural complications, code assignment is based on the provider’s documentation of the relationship between the condition and the procedure” (Section I.C.17.f.1.a) Further, the Guidelines specify that “for reporting purposes, the definition for “other diagnoses” is interpreted as additional conditions that affect patient care in terms of requiring clinical evaluation; or therapeutic treatment; or diagnostic procedures; or increased nursing care and/or monitoring.” Coding Clinic reminded the questioner that  not all conditions that occur during or following surgery are classified as complications. First, there must be more than a routinely expected condition or occurrence. In addition, there must be a cause-and-effect relationship between the care provided and the condition, and an indication in the documentation that it is a complication. The coder cannot make the determination whether something that occurred during surgery is a complication or an expected outcome. Finally, they stated (emphasis added) Only a physician can diagnose a condition, and the physician must explicitly document whether the condition is a complication. If it is not clearly documented, the coder should query the physician for clarification.

Volume:  2011

Issue:  First 

Title:  Superior Semicircular Canal Dehiscence Syndrome

The question was regarding a 53-year-old male who presented  with “left superior semicircular canal dehiscence syndrome (SSCDS).” What is the correct code assignment for this syndrome?

Coding Clinic answered to assign code 386.8, Other disorders of labyrinth, along with code 733.99, Other disorders of bone and cartilage, for SSCDS. In addition, codes for any other manifestations of the syndrome that are present should be coded.  Coding Clinic noted that treatment can involve reparative surgery, resurfacing the dehiscence of the semicircular canal, and that the etiology of the syndrome is unknown.

We'll post more rulings on Monday.  Have a great weekend.

Common ICD-9-CM Coding Errors

Usually, it’s a misunderstanding the rules of ICD-9 –but no matter the reason, many codes are found to be unsupported in a Risk Adjustment Data Validation or other audit.  The most common reasons for this seem to be that the ICD-9 doesn’t “talk” the way doctors do, or the person choosing the code doesn’t know that there’s a special rule related to it.  In an audit situation, the cause isn’t relevant—an error is an error.  The best way to avoid these errors is to make physicians aware of these common problems, and help them understand the ICD-9 rules.  Remember that those rules include Coding Clinic, which is officially tasked with clarifying coding rules for ICD-9.  So, what are the most common errors we see?

“Wound care” coding – Every time I drive by a wound care clinic, or see wound care written in a chart, I cringe.   I know that there’s a coding error ahead.  When you search the alphabetic index of the ICD-9 for the term wound, you won’t find any decubitus or vascular ulcers. You’ll see operative wounds (incisions) or lacerations (cuts).  I *know* what the provider means – he/she is treating an ulcer.  But if the doctor doesn’t call it an ulcer, choosing an ulcer code is wrong.  Physicians need to be instructed in the proper documentation for ulcers—location and type of ulcer must be described for vascular ulcers. For decubitus ulcers, the location, type (decubitus/pressure) and stage of ulcer must be documented.  For decubitus ulcers, two codes must be selected—one for the location and one for the stage.

Coronary Artery Disease (CAD) coding—Almost always, when I see a diagnostic statement of “CAD”, the code 414.00 (coronary artery disease, of unspecified type of vessel, native or graft) is attached.  Isn’t that correct? It sounds correct. No one mentioned whether it was a native or graft vessel, so it has to be correct! Except that it’s not. If there is no record of prior coronary artery bypass grafting, the correct code is 414.01 (coronary artery disease, of native coronary artery), because there’s a Coding Clinic that says so.  In Q2 1995, the following Coding Clinic ruling was issued:

Is it appropriate to assign code 414.01, Coronary atherosclerosis, of native coronary artery, if the medical record documentation does not indicate that the patient has a history of prior coronary artery bypass surgery?

Answer:
"Assign code 414.01, Coronary atherosclerosis, of native coronary artery, if medical record documentation shows no history of prior coronary artery bypass. If the documentation is unclear concerning prior bypass surgery, query the physician."

Aortic Atherosclerosis coding – Documentation that indicates “aortic atherosclerosis” or “atherosclerosis of the aorta” without further clarification cannot be coded according to Coding Clinic, Q4, 1988.  If the physician can be queried (i.e., the note is new, and can be amended within approximately 72 hours of the visit) then the physician can clarify whether it is the aorta (vessel) or the aortic valve.  If it is the vessel, then the correct coding is 440.0.  Atherosclerosis of the aortic valve is coded 424.1.  Going forward, the physician should be sure to clarify whether it is valve or vessel.  For example, noting that there is atherosclerosis of the abdominal aorta makes it clear that it is the vessel.

Hemiparesis vs. Weakness -  We often see documentation that states “history of CVA with R. sided weakness”, and the physician has selected 438.20 –late effect of CVA, hemiparesis/hemiplegia of unspecified side.  While paresis does mean weakness, the issue is a little more complicated.  The term hemiparesis means more than weakness, it means weakness affecting an entire side of the body. And, in this case, it’s not just about the definition—but coding rules.   In Q1 2005, Coding Clinic was asked the following question:

Please provide clarification on the correct code assignment for a residual deficit of muscle weakness secondary to late effect of cerebrovascular accident. We have a difference of opinion on whether this should be coded to code 438.2x, Late effects of cerebrovascular disease, hemiplegia/ hemiparesis. What is the appropriate code assignment for residual weakness that is a late of effect of CVA?
Answer:
Assign code 438.89, Other late effects of cerebrovascular disease and code 728.87, Muscle weakness, for residual muscle weakness secondary to late effect of cerebrovascular accident.
Therefore, when the physician documents weakness secondary to an old CVA, you cannot code 438.20.  Physicians must be educated regarding this rule, so that they can adjust their documentation going forward.

Finally, there’s a whole group of diagnoses that are coded when the physician really means that the patient had them in the recent past.  We see this most often when a patient is seen for the first time in the office after a hospitalization for:

                        CVA

      Sepsis

      Acute MI (except in 1^st 8 weeks)

Acute Coronary Syndrome

Non-ST Elevation MI (NSTEMI)

Unstable Angina

Acute Respiratory Failure

Once the patient has been discharged from the hospital, these conditions should no longer be coded. In some cases, it’s appropriate to code the “history of” code, or the underlying condition.  But coding these conditions in the office setting is only appropriate if the patient presents in the office and is (generally) transported by ambulance to the hospital.

There are other common errors that we see, but these are among the most common.  Understanding coding rules can help you avoid these pitfalls.

Do you have questions about coding rules?  Leave us a comment or email your question to coding@scanhealthplan.com.

What's New In Coding Clinic?

As you know, Coding Clinic is the official interpreter of ICD-9 coding guidelines.  So, when coding guidelines are unclear, Coding Clinic makes an official ruling.  There are a number of new Coding Clinic rulings, some of which may come up in Risk Adjustment.

Some recent Coding Clinic postings:

Coding Clinic, 2010 Q3, Acute on Chronic Kidney Failure. –The questioner asked what the correct coding was if a patient with documented acute kidney failure and End Stage Renal Disease (ESRD).  In addition, they wanted to know if the acute kidney failure was an exacerbation of the chronic kidney failure.

Coding Clinic replied that these are two separate diseases, and if both were documented, both should be coded.

Coding Clinic, 2010 Q4, Hypertensive Urgency—The questioner asked what the correct coding assignment was for hypertensive urgency.

Coding Clinic replied that the physician should be queried to determine what the specific type of hypertension was.  If still not further specified, the correct code was 401.9, Essential Hypertension, unspecified.  The alphabetic index now (as of the 2011 ICD-9) indicates that hypertensive urgency is coded 401.9.

NOTE: Hypertensive Urgency is described as systolic blood pressure over 180 mm Hg or diastolic blood pressure above 120 mm Hg.   Like Hypertensive Emergency (hypertensive crisis), Hypertensive Urgency generally requires hospitalization.

Coding Clinic 2010, Q2 – Infection due to Dialysis Catheter – The questioner asked what the correct code for infection due to a dialysis catheter. 

Coding Clinic replied that coding would be dependent on where the catheter was placed, i.e., if the infection is due to a centrally placed catheter, then the correct code is  999.31, Infection due to central venous catheter. If the infection is due to a peripherally placed catheter, then 996.62, Infection and inflammatory reaction, Due to vascular device, implant and graft is the correct code.

CMS Announces Partial Freeze of ICD-9/ICD-10 Codes

Today, CMS released a notice regarding a partial freeze of ICD-9-CM/ICD-10 Code sets prior to the ICD-10-CM implementation on October 1, 2013.

According to the ICD-10-CM notice, the freeze will be implemented as follows:

The partial freeze will be implemented as follows:

                        • The last regular annual update to both ICD-9 and ICD-10 code sets will be made on October 1, 2011.

                        • On October 1, 2012 there will be only limited code updates to both ICD-9- CM and ICD- 10 code sets to capture new technology and new  diseases.

                        • There will be no updates to ICD-9 -CM on October 1, 2013 as the system will no longer be a HIPAA standard.

Transcripts of the ICD-9-CM Coordination and Maintenance Committee meeting can be found at: http://www.cms.gov/ICD9ProviderDiagnosticCodes/03_meetings.asp.

Although we expect that CMS will provide a ICD-9 to ICD-10 crosswalk of the CMS-HCC model at some point, we don’t know when that will happen. 

You can read the CMS notice here, on the Tools Page at HCCUniversity.com.

New ICD-9 Codes Added to CMS-HCC Model

CMS published the new codes for the CMS-HCC model today on their website.  The new codes are effective 1-1-2011, and include a number of the new 2011 ICD-9 codes.  *While the ICD-9 codes are effective 10-1-2010, they are not included in the model until 1-1-2011.*

You can find the file on HCC University on our Tools Page.

The following codes have been added to the CMS-HCC or the RxHCC model:

Please note that there may be new codes added in 2011 due to changes in the CMS-HCC model.  The first (proposed) announcement of this will occur in February, with the final announcement of changes in April.  These changes will be posted here as soon as they become available.

Full Text 2011 ICD-9-CM Codes Posted On HCC University

We've posted the full text of the 2011 ICD-9-CM on HCC University.  You can find the following files on the Tools page:

• 2011 ICD-9-CM Guidelines
• 2011 ICD-9-CM Preface
• 2011 ICD-9-CM Diagnosis Disease Index
• 2011 ICD-9-CM Diagnosis Tabular Listing
• 2011 ICD-9-CM Procedures Index
• 2011 ICD-9-CM Procedures Tabular Listing

All files are effective 10-1-2010.  You can download these files to your desktop, for easy searching. 

We hope you find these files useful. 

What tools would you like to see on HCC University?  Let us know in our comments section, and we'll do what we can to make it happen.

New ICD-9-CM Codes for 2011 (Effective Date 10-1-2010)

We’ve posted a copy of the new, revised and deleted ICD-9-CM codes for 2011 codes on our Tools page (Tools) As soon as the full text copies of ICD-9 have been posted, we’ll post them there too.

Note that CMS has not indicated which, if any, of these codes will be included in the CMS-HCC risk adjustment model.  As soon as new information becomes available, we’ll post it here.